Related to: Hate Crime and Hate Incidents, Sexual Health, Ethnicity, Wellbeing, Mental Health and Illness, Smoking, Ill Health and Disability, Physical Activity, Sex and Gender, Healthy Weight, Domestic Abuse Victims

Key Facts:

  • There are likely to be approximately 3,900 adult residents of B&NES who are lesbian, gay or bisexual.
  • LGB groups are more likely to be vulnerable to adverse health and wellbeing outcomes compared to the general population, including: hate crime, domestic violence, shorter life expectancy, higher rates of smoking, poorer sexual health, higher rates of self-harm and suicide, school absenteeism and homelessness.

What does the data say?

PHE estimates an overall proportion of 2.5% of the population self-identifying as LGB, as aggregated from 22 key surveys. 1 This would equate to nearly 3,900 persons aged 16+ in B&NES.    

The Gender Identity Research and Education Society (GIRES) estimates the number of Transgender people in the UK at 1% of the population being on a “gender variant spectrum”.2  This would give a population of approximately 1,760 Transgendered people living in B&NES.

However, some Lesbian, Gay, Bisexual an Transgendered and Undecided (LGBT and U) people do not “come out” because they fear being treated worse as a result, for example, experiencing negative attitudes and/or homophobia.3

Hate Crime and Hate Incidents

National Data

In 2013, YouGov, commissioned by Stonewall,4 surveyed more than 2,500 lesbian, gay and bisexual people across Britain to investigate their experiences of homophobic hate crimes and incidents.

  • In 2013 hate crimes and incidents remain a serious issue in Britain with one in six lesbian, gay and bisexual people experiencing a homophobic hate crime or incident over the last three years.
  • One in ten experiencing a homophobic hate crime or incident were physically assaulted.
  • Almost one in five victims were threatened with violence or the use of force.
  • One in eight victims experienced unwanted sexual contact.
  • One in eight victims have had their home, vehicle or property vandalised.
  • Harassment, insults and intimidation are most common, reported by more than eight in ten lesbian, gay and bisexual people who have suffered a hate crime or incident.

Local Data

There were 167 hate crimes in B&NES reported to the police between 2010/11, 11% of which were related to homophobic or transgenderphobic hate crime.

Domestic Abuse 5

There is a significant peer-review published and grey evidence base relating to increased levels of domestic violence and abuse experienced by LGB individuals.

  • Half of gay and bisexual men have experienced at least one incident of domestic abuse from a family member or partner since the age of 16 compared to 17% of men in general.
  • 4 in 5 gay and bisexual men who have experienced domestic abuse have never reported incidents to the police. Of those who did report, more than half were not happy with how the police dealt with the situation.
  • 1 in 4 lesbian and bisexual women have experienced domestic violence in a relationship. (This is comparable to the 1 in 4 of the general population of women who have experienced domestic violence.)
  • 4 in 5 lesbians and bisexual women who have experienced domestic abuse have never reported incidents to the police. Of those who did report, 49% were happy with how the police dealt with the situation. 

Recent research found that 63% of gay and bisexual men and 39% of lesbian and bisexual women living with a disability had experienced domestic violence from a family member, partner or ex-partner since the age of 16yrs.  This would suggest that there may be more risks associated with remaining at home for LGB individuals with a learning disability if they express their sexual or gender identity at home.

Ill Health and Disability

Life expectancy in the LGB population has not been modelled in the UK.  International studies have found the life expectancy of gay men to be up to 20 years less than their heterosexual counterparts, but most of this was attributable to HIV and subsequent work has suggested that the gap in life expectancy due to HIV is reduced substantially by treatment.6  However, research in Denmark found that, despite the positive impact of same-sex marriage, individuals in same-sex relationships had a significantly higher mortality rate than the general population. 7

 

Lifestyle (Physical Activity, Healthy Weight and Smoking) 8

  • Research suggests that gay and bisexual men are less likely to achieve Physical Activity recommendations than men in general, despite this, gay and bisexual men are less likely to be overweight than heterosexual men. 44% of gay and bisexual men are overweight or obese compared to 70% of men in general.
  • UK research has found similar BMI levels for lesbian and bisexual women and heterosexual women (International research suggests lesbian and bisexual women are more likely to be overweight and obese than heterosexual women) despite this research shows that lesbian and bisexual women are more likely than women in general to get regular exercise. 
  • Two thirds of lesbian and bisexual women have smoked compared to half of women in general, and just over a quarter are active smokers.  A quarter of gay and bisexual men currently smoke compared to 22% of men in general, and two thirds have smoked at some time in their life compared to half of men in general.  LGB people over 16yrs are more likely to be current smokers, less likely to have never smoked, and less likely to have given up smoking than the general population.

 

Sexual Health

Some Lesbian, Gay, Bisexual, Transgendered and Undecided (LGBT and U) groups experience inequalities in sexual health.  Nationally, there is a particularly high prevalence and incidence of STIs amongst gay and bisexual men, particularly infections such as syphilis, gonorrhoea, chlamydia and HIV.9 10  One study indicates less than half of lesbian and bisexual women have ever been tested for STIs; over half of lesbian and bisexual women who have been tested for STIs have had an infection, and over half of lesbian and bisexual women have never been for a sexual health check-up.11

A Men who have Sex with Men (MSM) Sexual Health Needs Assessment was undertaken in B&NES in 2010.12  The key findings from the survey were:

  • There was variable knowledge of STIs and limited access to “fast” community HIV testing.
  • Usage of condoms during sex amongst MSM above the national average (89% compared to 48.3% nationally).
  • Public Sex Environment (PSE) usage was high in the group, with 47.3% identifying as using PSEs.  However, many are using Junction 18 on the M4 and Tog Hill, both outside of B&NES locality, along with public toilets and other areas.  It was noted that more and more MSM are using the internet to find sexual partners and then often meeting at a PSE to engage in sexual acts.
  • There were no clear areas that MSM seemed to indicate were lacking in terms of service provision, with the one exception of a possible community based fast HIV testing programme.
While the vast majority do not have HIV, Gay and Bisexual men and other men who have sex with men (MSM), continue to be the group most affected by HIV infection nationally.  In 2013, an estimated 43,500 MSM were living with HIV in the UK; this is equivalent to 59 per 1,000 MSM aged 15-59 years.13
 
B&NES is a low prevalence area for HIV, with 0.66 infections per 1,000 population aged 15-59 years, compared to 2.1 per 1,000 in England.  The number of new diagnosis of HIV in B&NES has fluctuated.  In the five years from 2009 to 2013, 35 people in B&NES have been newly diagnosed with HIV, of which 23 (66%) were MSM.  In terms of people living with HIV and receiving HIV-related treatment and care, it is estimated that 45% of this cohort acquired HIV as a result of sex between men.14
 
Syphilis is an uncommon sexually transmitted infection in B&NES, but the majority of diagnoses during 2010 to 2013 occurred in Gay and Bisexual men, mirroring national trends (73% of syphilis infections in England occurred in Gay and Bisexual men during 2013).15
 
There is variable data available on how LGBT and U groups access sexual health services.  Gay men in B&NES appear to be accessing GUM services, but in low numbers, (c.200 first attendances per annum) and there are very low numbers of bisexual people attending GUM services.  There is no data available locally on the numbers of Transgendered people accessing the service and it is extremely difficult to get any meaningful data on the numbers of those Undecided.  Fear of “coming out” may also add to the reluctant for people attending services to disclose their sexual orientation.  Targeting LGBT and U groups in B&NES also made more difficult due to the lack of any recognised LGBT and U scene in B&NES.16
 
For more information on contraception in the Sexual Health Needs Assessment please refer to the 2015 Bath and North East Somerset Rapid Sexual Health Neads Assessment - available from Sexual Health.
 

Mental Health and Wellbeing 17

  • Mental ill health is more prevalent among LGB&T people than in the wider population, although due to a lack of sexual orientation and gender identity monitoring, there is little data on LGB&T people’s access of secondary mental health services.
  • There is evidence to suggest that LGB&T people experience poor care in mental health services.
  • Research has consistently shown high levels of self-harming among LGB&T people, particularly young people.  Over half (56%) of LGB young people have deliberately harmed themselves.  Self-harm is directly linked with experience of homophobic bullying.
  • Research shows that LGB&T people are more likely to attempt suicide compared to the wider population.
  • The national standards on treatment and care to support trans people states that ‘trans people suffer enormous social isolation as one of the most marginalised groups in society’, acknowledging the extreme potential for social isolation.  This statement is supported by a growing body of evidence which demonstrates that social isolation of trans individuals is a significant barrier to seeking health and medical support until crises occur and contributes to serious mental ill health and suicidal intent.
  • Evidence strongly suggests that LGB&T individuals, especially trans individuals, will experience significantly higher social isolation than the general population - 54% of LGB people have experienced feelings of isolation and 1 in 5 older LGB people have no one to contact in times of crisis (as much as ten times the number in the general population).

Education 18

There is a body of evidence that LGB&T identification occurs in many people in childhood, and many children experience bullying and harassment in schools which can be a significant cause of persistent absenteeism:

  • Over half of secondary school pupils are victims of homophobic bullying in schools.
  • 46% of lesbian and gay pupils don’t feel able to be themselves at school, and 21% do not feel safe or accepted at school.
  • More than 2 in 5 LGB pupils who experience homophobic bullying skip school because of it.

In 2015 Bath & North East Somerset Council has been named by Stonewall as the best local authority in Britain for tackling homophobic bullying and celebrating difference in its schools.

Housing and Homelessness 19

  • As many as 1 in 3 homeless youth are LGB&T, and local LGB&T surveys have found that 22% of LGB&T people have been homeless at some point in their lives.  LGB homeless youth may experience additional challenges because of their sexual orientation, and there is evidence that some young people become homeless because they, or their families, are unable to deal with them being LGB.
  • 1 in 5 lesbian and gay people still expect to receive worse treatment when applying for social housing, this proportion rises to 1 in 4 among young (18-24) and older (over 55) gay people.

Children and Young People

Youth Chances Survey Summary 2014 20

Youth Chances is a social research project aiming to identify the needs of LGBTQ (Lesbian, Gay, Bisexual, Transgender and questioning) young people and improve the commissioning and provision of services to meet their needs. The report is based on work over 5 years for 16-25 yr olds in England on a sample of over 6,500 responses.

Key findings:

  • All respondents perceive that discrimination against LGBTQ people in general is still common and this is confirmed by the higher levels of discrimination, and disadvantage that young people experience.
  • LGBTQ young people feel substantially less accepted in their local community than their heterosexual, non-trans counterparts particularly in religious organisations and sport.
  • LGBTQ young people experience significantly higher levels of verbal, physical and sexual abuse.
  • Nearly 1 in 10 of LGBTQ young people (8%) have had to leave home for reasons relating to their sexuality or gender identity.
  • Most young LGBTQ people feel that their time at school is affected by hostility or fear, with consequences such as feeling left out, lower grades and having to move schools. Most report that their school supported its pupils badly in respect of sexuality or gender identity.
  • Schools also neglect areas that are known to be public health concerns. Sex and relationships education is not inclusive of LGB relationships and does not provide young people with the emotional and sexual health information they need. This is a particular concern for young gay and bisexual men who are at higher risk of STIs and HIV.
  • LGBTQ young people experience less discrimination at university and work, which are also rated as environments that are much more tolerant and supportive than school.

What does the community say?

LGB&T Research Report, November 2014

The Diversity Trust carried out the Bath & North East Somerset Lesbian, Gay, Bisexual and Trans (LGB&T) health and wellbeing survey in 2013-14. The survey was part of a community-based research project, being delivered by the Diversity Trust in partnership with researchers from Bath Spa University, funded by the Community Empowerment Fund.[fn]Diversity Trust (2014), Lesbian, Gay, Bisexual and Trans Health and Wellbeing in Bath and North East Somerset, available from: http://www.diversitytrust.org.uk/news/2014/11/27/lesbian-gay-bisexual-and-trans-health-and-wellbeing-in-bath-and-north-east-somerset/

Key findings:

  • Just over 50% of respondents had received help for anxiety and depression, with those aged 16-24, or from minority sexual orientations significantly more likely to have sought medical help.
  • Over 40% of the sample had thought about or attempted suicide, with LBG and trans respondents significantly more likely.
  • A Third of LGB&T respondents said they had encountered discrimination in their local area because of their gender identity and / or sexual orientation
  • Focus groups and open feedback suggested that incidences of discrimination and abuse had profound effects on mental health and wellbeing, particularly among young people.
  • A number of respondents reported reluctance to ‘come out’ when receiving a range of services, because of fear of being treated worse as a result.

The Child Health-Related Behaviour Survey 21

The Health-Related Behaviour Survey developed by the Schools Health Education Unit (SHEU) is designed for young people of primary and secondary school age. The surveys have been developed by health and education professionals, and cover a wide range of topics. Data arising from the survey can be used to help inform planning and policy decisions as well being used in the classroom as the stimulus for discussion with young people. These surveys are carried out every two years.

When considering the results of the Child Health-Related Behaviour Survey in B&NES it is worth bearing in mind the level of participation in the survey, and thus how representative the responses are likely to be of children in B&NES as a whole. For more information see the Child Health-Related Behaviour Survey section in Children and Young People

When the Child Health-Related Behaviour Survey in 2013 asked secondary school children in B&NES in year 10 about their sexual orientation:

  • 87% of pupils responded that they were straight/heterosexual.
  • 1% of pupils responded that they were gay/lesbian.
  • 1%  of pupils said they were bisexual
  • 1% said they were transgender/transsexual